Objective:To analyze the current status of red blood cell transfusion in very preterm infants (VPI) (gestational age at birth <32 weeks) from Chinese Neonatal Network (CHNN) in 2022.Methods:This cross-sectional study was based on the CHNN VPI cohort. It included 6 985 VPI admitted to CHNN 89 participating centers within 24 hours after birth in 2022. VPI with major congenital anomalies or those transferred to non-CHNN centers for treatment or discharged against medical advice were excluded. VPI were categorized based on whether they received red blood cell transfusions, their gestational age at birth, the type of respiratory support received during transfusion, and whether the pre-transfusion hemoglobin levels exceeded the thresholds. General characteristics, red blood cell transfusion rates, number of transfusions, timing of the first transfusion, and pre-transfusion hemoglobin levels were compared among different groups. The incidence of adverse outcomes between the group of VPI who received transfusions above the threshold and those who received transfusions below the threshold were compared. Comparison among different groups was conducted using χ2 tests, Kruskal-Wallis H tests, Mann-Whitney U test, and so on. Trends by gestational age at birth were evaluated by Cochran-Armitage tests and Jonckheere-Terpstra tests for trend. Results:Among the 6 985 VPI, 3 865 cases(55.3%) were male, with a gestational age at birth of 30.0 (28.6, 31.0) weeks and a birth weight of (1 302±321) g. Overall, 3 617 cases (51.8%) received red blood cell transfusion, while 3 368 cases (48.2%) did not. The red blood cell transfusion rate was 51.8% (3 617/6 985), with rates of 77.7% (893/1 150) for those born before 28 weeks gestational age and 46.7% (2 724/5 835) for those born between 28 and 31 weeks gestational age. A total of 9 616 times red blood cell transfusions were administered to 3 617 VPI, with 632 times missing pre-transfusion hemoglobin data, and 8 984 times included in the analysis. Of the red blood cell transfusions, 25.6% (2 459/9 616) were administered when invasive respiratory support was required, 51.3% (4 934/9 616) were receiving non-invasive respiratory support, while 23.1% (2 223/9, 616) were given when no respiratory support was needed. Compared to the non-transfusion group, the red blood cell transfusion group had a higher rate of pregnancy-induced hypertension in mothers, lower rates of born via cesarean section and mother′s antenatal steroid administration, smaller gestational age, lower birth weight, a higher proportion of small-for-gestational-age, multiple births, and proportions of Apgar score at the 5 th minute after birth ≤3 (all P<0.05). They were also less likely to be female, born in hospital or undergo delayed cord clamping (all P<0.01). Additionally, higher transport risk index of physiologic stability score at admission were observed in the red blood cell transfusion group ( P<0.001). The number of red blood cell transfusion was 2 (1, 3) times, with the first transfusion occurring at an age of 18 (8, 29) days, and a pre-transfusion hemoglobin level of 97 (86, 109) g/L. For VPI ≤7 days of age, the pre-transfusion hemoglobin levels for invasive respiratory support, non-invasive respiratory support, or no respiratory support, respectively, with no statistically significant differences between groups ( H=5.59, P=0.061). For VPI aged 8 to 21 days and≥22 days, the levels with statistically differences between groups (both P<0.01). Red blood cell transfusions above recommended thresholds were observed in all respiratory support categories at different stages of life, with the highest prevalence in infants aged 8 to 21 days and≥22 days who did not require respiratory support, at 90.1% (264/273) and 91.1%(1 578/1 732), respectively. The rate of necrotizing enterocolitis was higher in the above-threshold group ( χ2=10.59, P=0.001), and the duration of hospital stay was longer in the above-threshold group ( Z=4.67, P<0.001) compared to the below-threshold group. Conclusions:In 2022, the red blood cell transfusion rate was relatively high among VPI from CHNN. Pre-transfusion hemoglobin levels frequently exceeded recommended transfusion thresholds.

Objective To investigate the prevalence of Schistosoma japonicum infections in wild rodents in schistosomiasis-endemic areas of China, so as to provide insights into formulation of technical guidelines for monitoring of and the precise control strategy for S. japonicum infections in wild rodents during the elimination phase. Methods Two administrative villages where schistosomiasis was historically highly prevalent were selected each from Dongzhi County, Anhui Province, and Duchang County, Jiangxi Province as study villages. Wild rodents were captured from study villages with baited traps or cages at night in June and September, 2021. The number of rodents captured was recorded, and the rodent species was characterized based on morphologi-cal characteristics. Liver tissues were sampled from captured rodents for macroscopical observation of the presence of egg granu- lomas, and S. japonicum infection was detected simultaneously using liver tissue homogenate microscopy, examinations of mesenteric tissues for parasites, and modified Kato-Katz thick smear technique (Kato-Katz technique). A positive S. japonicum infection was defined as detection of S. japonicum eggs or adult worms by any of these methods. The rate of wild rodent capture and prevalence of S. japonicum infections in wild rodents were compared in different study villages and at different time periods, and the detection of S. japonicum infections in wild rodents was compared by different assays. Results The overall rate of wild ro- dent capture was 8.28% (237/2 861) in Dongzhi County, and the wild rodent capture rates were 9.24% (133/1 439) and 7.31% (104/1 422) in two study villages (χ² = 3.503, P = 0.061), and were 8.59% (121/1 409) and 7.99% (116/1 452) in June and September, 2021, respectively (χ² = 0.337, P = 0.561). The overall rate of wild rodent capture was 3.72% (77/2 072) in Duchang County, and the wild rodent capture rates were 6.91% (67/970) and 0.91% (10/1 102) in two study villages (χ² = 51.901, P < 0.001), and were 4.13% (39/945) and 3.37% (38/1 127) in June and September, 2021, respectively (χ² = 0.815, P = 0.365). Rattus norvegicus was the predominant rodent species captured in both counties, accounting for 70.04% (166/237) of all captured wild rodents in Dongzhi County and 88.31% (68/77) in Duchang County. No S. japonicum infection was detected in wild rodents captured in Duchang County. Nevertheless, the overall prevalence of S. japonicum infections was 51.05% (121/237) in wild rodents captured in Dongzhi County, with prevalence rates of 50.38% (67/133) and 51.92% (54/104) in two study villages (χ² = 0.098, P = 0.755), and 54.31% (63/116) and 47.93% (58/121) in September and June, 2021, respectively (χ² = 0.964, P = 0.326). Of 237 wild rodents captured in Dongzhi County, there were 140 (59.07%) rodents with visible hepatic egg granulomas, 117 (49.47%) tested positive for S. japonicum eggs by liver tissue homogenate microscopy, 34 (14.35%) tested positive for S. japonicum eggs with Kato-Katz technique; however, no adult S. japonicum worms were detected in mesenteric tissues. In addition, hepatic egg granulomas were found in all wild rodents tested positive for S. japonicum eggs with liver tissue homogenate microscopy. Conclusions The rate of wild rodent capture and prevalence of S. japonicum infection in wild rodents vary greatly in schistosomiasis-endemic areas of China, and the prevalence of S. japonicum infection is slightly higher in wild rodents captured in autumn than in summer. Liver tissue is recommended as the preferred sample for surveillance of S. japonicum infection in wild rodents, and a combination of macroscopical observation of hepatic egg granulomas and liver tissue homogenate microscopy may be a standard method for surveillance of S. japonicum infection in wild rodents.

Objective To observe the impact of cold circulation liquid temperature on ablation focus morphology of microwave ablation(MWA)for in vitro porcine liver tissue.Methods Twenty in vitro fresh porcine liver blocks were randomly divided into ice water circulation group(group A)and normal temperature circulation group(group B),respectively.Ten target ablations in each subgroups in group A and group B,i.e.A1 and B1(50 W,1 min),A2 and B2(50 W,5 min),A3 and B3(60 W,1 min),A4 and B4(60 W,5 min),A5 and B5(70 W,1 min)as well as A6 and B6(70 W,5 min)subgroups were performed using different ablation power(50,60,70 W)and ablation time(1,5 min),respectively.Then the morphology indexes of ablation foci,including longitudinal diameter(LD),transverse diameter(TD),roundness index(RI)and volume(V)were compared between subgroups in group A and B,also among subgroups within group A and B.Results Under the same ablation power and time,LD of ablation foci in subgroups of group A were all smaller than those of group B(all P＜0.05).Significant differences of RI of ablation foci were found between A1 and B1,A2 and B2,A4 and B4,A5 and B5 as well as A6 and B6 subgroups(all P＜0.05),but not between A3 and B3 subgroups(P＞0.05).However,the main effect of cold circulation liquid temperature on ablation focus TD(F=1.125)nor V(F=3.332)was not significant(both P≥0.05).Under the same cold circulation liquid temperature,significant differences of the morphology indexes of ablation foci were detected between A1 and A2,A3 and A4 as well as A5 and A6 subgroups,also between corresponding subgroups in group B(all P＜0.05).Conclusion During MWA for in vitro porcine liver tissue under constant ablation power and time,taken ice water as the cold circulation liquid was benefit to ablation focus shaped spherically.With the extension of ablation time,the larger the ablation focus,the higher the RI.

Objective To investigate the clinical features and risk factors for deep vein thrombosis(DVT)of the lower ex-tremities in burn patients.Methods The clinical data of 155 burn patients admitted to Wuhan Third Hospital from January 2021 to January 2023 were retrospectively analyzed.The patients were divided into DVT group and non-DVT group according to whether they had concurrent DVT during hospitalization.Two groups of baseline data were compared[sex,age,body mass in-dex(BMI),coexisting diseases,smoking,drinking,DVT history of the lower limbs,burn cause,burn site,burn degree,central venous catheter retention in the femoral vein,wound infection,low-molecular-weight heparin application,time in bed,and labora-tory indicators[D-dimer(D-d),fibrinogen(FIB),homocysteine(Hey)].The levels of tumor necrosis factor α(TNF-α)and C-reac-tive protein(CRP)differed,and the risk factors for DVT in burn patients were determined via multivariate logistic regression a-nalysis.Finally,this study analyzed the value of BMI,time in bed,D-dimer,fibrinogen,Hcy,TNF-α,and CRP in predicting DVT in burn patients via receiver operating characteristic(ROC)curves.Results There were no significant differences between the two groups in terms of sex,combined disease,smoking or drinking,or cause of burn(all P＞0.05).The following risk factors were found to be significantly greater in the group with deep vein thrombosis(DVT)than in the group without DVT:age 60 years or older,history of lower limb DVT,lower limb burn of degree Ⅱ or above covering 30％or more of the area,femoral vein indentation central venous catheter,wound infection,and lack of low-molecular-weight heparin treatment.Additionally,BMI,D-dimer levels,fibrinogen levels(FIB),homocysteine(Hcy)levels,TNF-α levels,and C-reactive protein(CRP)levels were signifi-cantly higher in the DVT group than in the non-DVT group.The time in bed was significantly longer in the DVT group than in the non-DVT group(P＜0.01).Multivariate logistic regression analysis confirmed that the risk factors for DVT in burn pa-tients included age ≥60 years,history of lower extremity DVT,lower extremity burn,burn degree Ⅱ or above,burn area≥30％,femoral vein indwelling central venous catheter,wound inf ection,lack of low-molecular-weight heparin application,increased BMI,elevated levels of D-dimer,FIB,Hcy,TNF-α,and CRP,and prolonged time in bed.ROC analysis confirmed that BMI,time in bed,D-d,FIB,Hcy,TNF-α and CRP could all be used to predict DVT in burn patients,and the areas under the curve were 0.844,0.853,0.890,0.817,0.892,0.962 and 0.776,respectively,(all P＜0.01).Conclusion Burn patients complicated with DVT are affected by many factors.Moreover,ROC analysis confirmed that BMI,time in bed,D-d,FIB,Hcy,TNF-α and CRP could be indicators for predic-ting DVT,which should be considered in the subsequent clinical treatment of such patients.

Objective:To study the impact factors of computed tomography(CT)imaging quality of inner ear under different reconstruction algorithms,and to explore the feasibility and application value that different reconstruction algorithms reduced the CT scanning dose for inner ear.Methods:Based on the head phantom,fixed tube currents of 100,80,70,60,50,and 40 mA were respectively used to perform high-resolution CT(HRCT)of multi-slice spiral volume at transverse section.Each tube current was used to conduct 25 example number of scanning experiments.Different reconstruction parameters were used to reconstruct images by using three commonly reconstruction techniques for inner ear CT,which included volume rendering technique(VRT),multiple planar reconstruction(MPR)and maximum intensity projection(MIP).The effects of different tube currents and reconstruction parameters on the quality scores of soft tissue,bone,and artifacts in VRT,MPR and MIP images were analyzed and compared.Four physicians used a blind method to score the image quality as a scale of 0-3.Results:Under the same tube current,the quality scores of soft tissue,bone and artifact of VRT,MPR and MIP images gradually decreased with the increasing of reconstruction interval,and the differences were statistically significant(F=61.853,49.296,71.280,P<0.05),respectively.Under the parameters of same reconstruction interval,the quality scores of soft tissue,bone and artifact of VRT,MPR and MIP images gradually decreased with the decreasing of tube current during scanning,and the differences were statistically significant(F=16.346,23.632,21.746,P<0.05),respectively.The quality scores of soft tissue,bone and artifacts of images were positively correlated with tube current(r=0.892,0.907,0.871,P<0.05),and were negatively correlated with reconstruction interval(r=-0.841,-0.864,-0.866,P<0.05),respectively.Conclusion:In CT scanning of inner ear,the decrease of reconstruction interval can effectively improve the imaging qualities of thin-layer and low-dose scans,and further reduce the CT radiation dose of inner ear,which has clinical feasibility and application value.

ObjectiveMyelodysplastic syndromes （MDS） is a group of clonal hematopoietic stem cell disorders，and this study aims to investigate the expression of hypoxia-inducible factor-1α（HIF-1α） in the bone marrow cells of patients with MDS and its correlation with the clinical features of MDS，the therapeutic efficacy of arsenic-containing Chineseherbal compound，and the survival prognosis. MethodAccording to the inclusion and exclusion criteria，27 MDS patients treated with arsenic-containing Chinese herbal compound in the Department of Hematology，Xiyuan Hospital，China Academy of Chinese Medical Sciences from January 2022 to September 2022 were included，and their bone marrow samples were collected by myelotomy. HIF-1α expression level in bone marrow cells was detected by real-time polymerase chain reaction （PCR） to analyze its correlation with clinical features，and logistic and Cox regression was used to analyze the risk factors affecting the efficacy and prognostic survival of MDS patients. ResultThe HIF-1α mRNA expression level was lower in bone marrow cells of MDS patients than in healthy subjects. HIF-1α was positively correlated with the degree of myelodysplasia（r=0.384，P<0.05） and bone marrow granulocytic system%（G%）（r=0.560，P<0.01）. Logistic regression showed that HIF-1α was a risk factor for the prognosis in the follow-up of the efficacy of treatment（P<0.05）and Cox regression showed that HIF-1α was an independent factor affecting the survival prognosis of MDS patients ［odds ratio（OR）=398.968，95% confidence interval（CI）（1.281，116 858.743），P<0.05］. ConclusionThe level of HIF-1α expression in bone marrow cells of MDS patients was closely related to the degree of clinical myelodysplasia and G%，and HIF-1α was a risk factor for the efficacy for and survival prognosis of MDS patients.

Objective:To study the feasibility and value of applying organ dose modulation technique in computed tomography(CT)scanning on eyes.Methods:A total of 330 patients who admitted to Beijing Friendship Hospital affiliated with Capital Medical University from August 2021 to August 2023 and underwent CT examination on eyes were selected.They were divided into modulation group,conventional group and low-dose group based on the control methods of tube current in scanning.The modulation group used organ dose modulation technique with intelligent automatic tube current of 70-150 mA,and the conventional dose group used a fixed tube current of 100 mA,and the low-dose group used a fixed tube current of 70 mA.The differences in radiation dose and CT imaging quality among 3 groups were compared.Results:The dose length product(DLP),volume CT dose index(CTDIvol)and effective dose(ED)of cross-sectional scan of the modulation group were respectively 62.37,12.83 and 0.143 mSv,which were significantly lower than 115.23,18.93 and 0.265mSv of conventional dose group,respectively,with statistically significant(F=2544.944,6009.596,2544.944,P<0.05).The DLP,CTDIvol and ED of coronary scan of the modulation group were 68.19,13.15 and 0.156,respectively,which were significantly lower than 122.41,19.20 and 0.282 mSv of the conventional dose group,respectively,with statistically significant(F=1232.413,3813.940,1232.413,P<0.05).The excellent rates of cross-sectional scans among the modulation group,conventional group and lower-dose group were respectively 98.83%,86.15%and 47.69%,and the difference among three groups was statistically significant(x2=53.908,P<0.05).The excellent rates of image qualities of the modulation group,conventional group and low-dose group were respectively 96.61%,80.70%and 48.28%,and the difference among three groups was statistically significant(x2=20.992,P<0.05).Conclusion:The application of organ dose modulation technique in CT scanning on eyes can significantly reduce radiation dose on patient under ensures imaging quality can meet diagnostic needs when undergoes cross-sectional and coronal scans,which has higher clinical feasibility and application value.

Objective:To evaluate the efficacy and safety of oliceridine for treatment of moderate to severe pain after surgery with general anesthesia in patients.Methods:The patients with moderate to severe pain (numeric pain rating scale ≥4) after abdominal surgery with general anesthesia from 14 hospitals between July 6, 2021 and November 9, 2021 were included in this study. The patients were assigned to either experiment group or control group using a random number table method. Experiment group received oliceridine, while control group received morphine, and both groups were treated with a loading dose plus patient-controlled analgesia and supplemental doses for 24 h. The primary efficacy endpoint was the drug response rate within 24 h after giving the loading dose. Secondary efficacy endpoints included early (within 1 h after giving the loading dose) drug response rates and use of rescue medication. Safety endpoints encompassed the development of respiratory depression and other adverse reactions during treatment.Results:After randomization, both the full analysis set and safety analysis set comprised 180 cases, with 92 in experiment group and 88 in control group. The per-protocol set included 170 cases, with 86 in experiment group and 84 in control group. There were no statistically significant differences between the two groups in 24-h drug response rates, rescue analgesia rates, respiratory depression, and incidence of other adverse reactions ( P>0.05). The analysis of full analysis set showed that the experiment group had a higher drug response rate at 5-30 min after giving the loading dose compared to control group ( P<0.05). The per-protocol set analysis indicated that experiment group had a higher drug response rate at 5-15 min after giving the loading dose than control group ( P<0.05). Conclusions:When used for treatment of moderate to severe pain after surgery with general anesthesia in patients, oliceridine provides comparable analgesic efficacy to morphine, with a faster onset.

Objective: To investigate the effects and mechanisms of Xuebijing injection (XBJ) on Chimeric antigen receptor-T (CAR-T) cell function and its therapeutic potential against CAR-T therapy-associated cytokine storms (CRS). Methods: Anti-CD19 CAR-T cells were established based on FMC63 antibodies. Different doses of XBJ (1 and 10 mg/mL) were added to the culture system. Untreated anti-CD19 CAR-T cells served as negative controls. After 48-h co-culture, the effects of XBJ on CAR-T cell function were assessed. Carboxyfluorescein diacetate succinimidyl ester staining was used to assess the effect of XBJ on CAR-T cell proliferation. Flow cytometry, luciferase reporter gene assays, and real time cellular analysis were employed to evaluate the effects of XBJ on CAR-T cell cytotoxicity in vitro. RNA-sequencing was performed to analyze the effects of XBJ on CAR-T cell gene expression. Network pharmacology predicted potential XBJ therapeutic targets for CRS, which were verified in a THP-1 macrophage inflammation model. Results: XBJ enhanced both the proliferation and tumor killing capacities of CAR-T cells. Transcriptome analysis showed that XBJ treatment affects multiple genes and pathways in CAR-T cells, with differential gene enrichment in multiple cell proliferation and growth factor pathways. Potential targets for CRS control by XBJ were predicted using network pharmacology, and the inhibitory effect of XBJ on the expression of relevant genes was verified using a macrophage model. Conclusion The results of this study indicate that XBJ can enhance the killing effect of CAR-T cells on tumor cells and that the mechanism is related to the regulation of T cell proliferation and activation. Moreover, XBJ inhibited excessive inflammation associated with CAR-T therapy. However, the current findings remain to be further validated through in vivo experiments.

A middle-aged male came to Peking Union Medical College Hospital for treatment because of "pain for 10+ years, aggravated with emotional instability for 5 years". The patient's pain had a huge impact on life, with poor results even after repeated diagnosis and treatment in other hospitals. After multi-disciplinary discussion, it had been clarified that the pain was mainly caused by gout. The disease was heavily influenced by psychosocial factors. Therefore, the patient fits the diagnosis of "Psychological and Behavioral Factors Affecting Physical Diseases". The multi-disciplinary comprehensive management of the patient was carried out to identify and treat psychological factors affecting other medical conditions. After this mental treatment was performed, the patient's conditions significantly improved. The diagnosis and treatment of this patient demonstrates the importance of the multi-disciplinary treatment team for somatic symptoms (disorders).